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Lab Medicine > Hormones- Class 7 > Flashcards

Hormones- Class 7 Flashcards

1
Q

What are hormones?

A

Secretions that may produce a response at a near/remote site. Their actions are selective and effective at very minute quantities.

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2
Q

What are 3 types of endocrine hormones?

A

-Proteins
-Steroid
-Aromatic Amine hormones

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3
Q

What is the source of polypeptide hormones?

A

Hypothalamus and pituitary glands
Oxytocin
ADH
GnRH
TSH
FSH
LH
hCG

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4
Q

How do polypeptide hormones get into cells?

A

Membrane bound receptors.

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5
Q

Do polypeptide hormones use transport proteins?

A

No.

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6
Q

What is special about LH, FSH, TSH (structurally)?

A

Dimers
- alpha subunits that are identical
-B chains differ to gives specificity

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7
Q

What characteristic is exploited to test for different polypeptide hormones like LH, FSH, and TSH?

A

Their different beta chains

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8
Q

What are steroids made from?

A

Cholesterol

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9
Q

What are the steroids that bud from cholesterol?

A

-Testosterone
-Progesterone
-Estradiol
-Androstenediol

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10
Q

Do steroids use transport proteins?

A

Yes- sex hormone binding globulin SHBG

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11
Q

What kind of receptors do steroids use?

A

Intracellular specific receptors
- Cytoplasmic receptors
-Nuclear receptors

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12
Q

What are the types of receptors for steroids? 4

A

Androgen
Estrogen
Progesterone
Corticosteroid

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13
Q

How does mifepristone work?

A

It is an abortion pill that chemically structured to mimic progesterone.

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14
Q

What are examples of aromatic amines?

A

Epi and norepi

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15
Q

What are the three levels of control?

A

1= Target organs
2= Pituitary
3= Hypothalamus

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16
Q

What hormones are secreted from hypothalamus?

A

CRH
TRH
GHRH
GHIH
PRF
PIH
GnRH

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17
Q

What hormones are associated with the anterior lobe of the pituitary gland?

A

ACTH
TSH
GH
PRL
FSH
LH

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18
Q

What hormones are associated with the posterior pituitary gland?

A

ADH
Oxytocin

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19
Q

Explain the GH path

A

GHRH released from hypothalamus, anterior pituitary secretes GH, the liver breaks down glycogen and adipocytes break down triglycerides, and IGF stimulates amino acid uptake by target cells, promoting protein synthesis

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20
Q

Increas GH causes what pathologies?

A

Acromegaly
Gigantism

21
Q

Decreased GH causes what pathology?

A

Dwarfism

22
Q

What is acromegaly?

A

Rare chronic endocrine disorder resulting from hyper-secretion of GH

Cause is normally pituitary adenoma leading to abnormal musculoskeletal growth, most often noted in the face/extremities

23
Q

GH can also be abused by?

A

Athletes and rich people

24
Q

When is oxytocin secreted?

A

In response to suckling

25
Q

What does oxytocin do in a female’s body?

A

Induces labor, controls postpartum uterine bleeding

26
Q

What are medications that are synthetic forms of oxytocin?

A

Pitocin and Syntocinon

Both to induce labor

27
Q

If osmolality increased by 1-2% what happens to ADH?

A

ADH increases 4 x

28
Q

If osmolality decreased by 1-2% what happens to ADH?

A

ADH turns completely off

29
Q

What are causes of hypofunction of the anterior pituitary gland?

A

Hypothalamic lesion
Pituitary adenoma like simmonds syndrom or sheehans
Postpartum hemmorrhage- hypovolemia
Genetic defect

30
Q

If all labs for TSH, LH, FSH, (anterior pituitary lobe hormones) are low- what do you expect?

A

Panyhypopituitarism

31
Q

How many layers does the adrenal gland have?

A

3
Zona glomerulosa
Zona fasciculata
Zona reticularis

32
Q

What are major pathologies of the adrenal gland?

A

Cushings
Addisons

33
Q

What is secreted from the adrenal medulla?q

A

Aromatic amines
EPI
NOREPI

34
Q

What is synthesized in the zona fasiculata and how is it stimulated?

A

Cortisol and it is stimulated by ACTH

35
Q

ACTH production is _. Cortisol peaks at _ AM

A

diurnal, 8:00

36
Q

What is the composition of cortisol in plasma?

A

90% bound to CBG corticosteroid binding globulin, 10% is free (biologically active)

37
Q

What is cortisol’s 1/2 life?

A

90 minutes

38
Q

Where is CBG synthesized?

A

Liver and is dependent on estrogen

39
Q

What is the pathway to making cortisol?

A

Cholesterol -> Pregnenolone -> progesteron -> 12-Hydroxyprogesterone -> 21-HYDROXYLASE ENZYME -> cortisol

40
Q

What would happen during pregnancy if CBG is dependent on estrogen?

A

If estrogen increases so does CBG

41
Q

How is cortisol measured?

A

Serum at 8:00 AM and rechecked at 4:00 PM
OR
Free cortisol can be checked by 24 hr urine specimen

42
Q

What would the lab values for Addison’s disease look like?

A

Low cortisol, high ACTH

43
Q

What are the symptoms of Addisons disease?

A

Weakness
weight loss
pigmentation of skin + mucus membranes*
Hypotension
Anorexia, naseau, vomiting
Salt Craving

44
Q

Is addisons a primary secondary or tertiary endocrine defect?

A

Primary

45
Q

What is the ACTH stimulation test

A

Tests Addisons Disease
Give ACTH
Test @ 30 min
Test again @ 60 min
If the cortisol level stays the same= primary Adrenal insufficiency (Addison’s disease)

46
Q

What is the metyraprone test?

A

Metyrapone inhibits the 11 beta hydroxylase enzyme that is needed to make Cortisol.

Normally, the decrease in cortisol should stimulate the pituitary secretion of ACTH by the negative feedback mechanism

(Shouldn’t be used in pt’s with addisons)

47
Q

What are three ways Cushing’s syndrome can be caused?

A

Hyperplasia of the adrenal gland,
Pituitary tumor,
Ectopic tumor causing adrenal gland to create more cortisol

48
Q

What are symptoms of Cushing’s syndrome?

A

Obesity
Hypertension
Glucosuria
Polyuria
Menstrual/sexual dysfunction
Striae
Bruising
Psychiatric disturbances
Osteoporosis
Edema

49
Q

What is the dexamethasone suppression test?

A

DEX is a synthetic cortisol.
You take 1 mg at 11:00 PM, cortisol is measured at 8:00 AM.

Normally, the high night cortisol should have turned off ACTH and lowered cortisol

Pts with Cushing’s will have no cortisol suppression. Problem: primary overproduction

Lab Medicine (2 decks)

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